Hospital bed

ABSTRACT

A patient support apparatus including a first patient support configured to be rotated about a longitudinal axis. The patient support apparatus is configured to receive an x-ray cassette. The first patient support illustratively includes an inflatable bladder.

CROSS-REFERENCE TO RELATED APPLICATIONS

[0001] This application is a continuation of U.S. application Ser. No.10/335,468, filed Dec. 31, 2002, now U.S. Pat. No. 6,691,347, which is acontinuation of U.S. application Ser. No. 09/944,558, filed Aug. 31,2001, now U.S. Pat. No. 6,499,160, which is a continuation of U.S.application Ser. No. 09/499,200, filed Feb. 7, 2000, now U.S. Pat No.6,282,736, which is a continuation PCT Application Ser. No.PCT/US98/16497, filed Aug. 7, 1998, which claims the benefit of U.S.provisional application Serial No. 60/055,043 filed Aug. 8, 1997 andU.S. provisional application Serial No. 60/090,212 filed Jun. 22, 1998,all of which are expressly incorporated by reference herein.

BACKGROUND AND SUMMARY OF THE INVENTION

[0002] The present invention relates to a hospital bed. Moreparticularly, the present invention relates to a proning bed whichpermits rotation of a patient supported on a patient support surface ofthe bed.

[0003] In an illustrative embodiment of the invention, a frame of thebed is operated to rotate the patient a full 360° about a longitudinalaxis of a patient support assembly. In other words, the patient can berotated 180° to prone the patient to aid with respiratory disorders suchas Acute Respiratory Distress Syndrome (ARDS), or in order to performsurgical procedures or to permit the patient to lie face down on thesupport surface. The present invention permits full 180° rotation of apatient located on a patient support surface while providing spinalstability for spinal trauma patients.

[0004] The present invention illustratively provides a cantilevereddesign which cantilevers the entire patient support assembly from a footend support assembly of the bed. No other support is required forrotation. The cantilevered design facilitates access to the head end ofthe bed which is substantially free from structural support. C-armaccess is provided over the entire patient support surface for full bodyimaging.

[0005] According to an illustrative embodiment of the invention, aproning bed comprises a frame, a first support member coupled to theframe and configured to be located adjacent a posterior side of apatient, and a second support member coupled to the frame and configuredto be located adjacent an anterior side of the patient. The proning bedfurther comprises a first patient support including an inflatablebladder, the first patient support being supported by the first supportmember and configured to support the patient in a supine position. Asecond patient support is supported by the second support member and isconfigured to support the patient in a prone position. The first supportmember and the second support member are configured to rotate the firstpatient support and the second patient support about a longitudinalaxis.

[0006] Illustratively, a rotatable drive mechanism is operably coupledto the first support member and the second support member, the drivemechanism being configured to rotate the first patient support and thesecond patient support about the longitudinal axis. The drive mechanismis further configured to rotate the first patient support and the secondpatient support by at least 180° about the longitudinal axis.

[0007] Further illustratively, the second patient support includes aninflatable bladder. A controller is configured to selectively inflateand deflate the inflatable bladder of the first patient support and theinflatable bladder of the second patient support.

[0008] Illustratively, a fluid supply is in fluid communication with theinflatable bladder of the first patient support and is configured toinflate and deflate the bladder.

[0009] Further illustratively, the first support member comprises atleast one pivotable door configured to provide access to the patient ina prone position, the inflatable bladder being coupled to the at leastone pivotable door. The second support member comprises at least onepivotable door configured to provide access to the patient in a supineposition.

[0010] Illustratively, a backboard is supported by the first supportmember, the backboard being removably coupled to the proning bed andconfigured to facilitate transport of the patient to and from theproning bed. The backboard includes at least one air bladder configuredto provide a pressure reducing surface for the patient. A plurality ofconnectors are configured to mechanically couple the backboard to theproning bed.

[0011] According to another illustrative embodiment of the invention, amethod for handling a patient on a proning bed is provided, the methodincluding the step of providing a proning bed having a bed support,first and second support members, and first and second patient supportscoupled to the first and second support members, at least one of thefirst and second patient supports including an inflatable portion, andthe patient being supported by the first patient support in a supineposition. The method further includes the steps of coupling the firstsupport member to the bed support, coupling the second support member tothe bed support, positioning a patient on the first patient support in asupine position, and inflating the inflatable portion. The method alsoincludes the step of moving the first support member and the secondsupport member so that the patient is supported by the second patientsupport in a prone position.

[0012] Illustratively, the first patient support includes an inflatableportion and the second patient support includes an inflatable portion. Afluid supply is configured to selectively inflate and deflate theinflatable portions of the first and second patient supports. The methodfurther illustratively includes the step of inflating the inflatableportion of the second patient support before the first and secondsupport members are moved.

[0013] Further illustratively, the step of inflating the inflatableportion comprises the step of inflating the inflatable portion of thefirst patient support. The method illustratively includes the furtherstep of deflating the inflatable portion of the first patient support.

[0014] Illustratively, the step of inflating the inflatable portioncomprises the step of inflating the inflatable portion of the firstpatient support before the first patient support is coupled to the bedsupport.

[0015] Illustratively, the method further includes the step of removingthe first support member after the step of moving the first supportmember and the second support member.

[0016] Illustratively, the method further includes the steps oftransporting the patient to the proning bed on a backboard, andremovably coupling the backboard to the bed support.

[0017] In another illustrative embodiment of the invention, a therapybed comprises a base, a frame coupled to the base, and a patient supportassembly coupled to the frame and configured to be rotated about alongitudinal axis. The patient support assembly includes a backboardhaving a first patient support surface. The backboard is removablycoupled to the frame to facilitate transport of the patient to and fromthe therapy bed.

[0018] Illustratively, the therapy bed further comprises a secondpatient support surface, the patient lying on the first patient supportsurface in a supine position, the first and second support surfacesconfigured to rotate by at least 180° about the longitudinal axis sothat the patient is lying on the second patient support surface in aprone position.

[0019] Illustratively, the backboard includes an inflatable portionwhich is deflated when the patient is in the prone position. The secondpatient support surface includes an inflatable portion which is inflatedwhen the patient is in the prone position. A fluid supply is configuredto selectively inflate and deflate the inflatable portion of thebackboard and the second support surface.

[0020] Further illustratively, the frame includes a rotatable drivemechanism coupled to the patient support assembly.

[0021] Illustratively, a plurality of connectors mechanically couple thebackboard to the frame.

[0022] In a further illustrative embodiment of the invention, a methodfor handling a patient on a therapy bed is provided, the methodincluding the steps of providing a backboard including a first patientsupport surface, positioning a patient on the first support surface in asupine position, and providing a therapy bed in spaced relation to thebackboard, the therapy bed including a base and a frame coupled to thebase. The method further includes the steps of transporting thebackboard to the therapy bed, releasably coupling the backboard to theframe, and rotating the first patient support surface of the backboardabout a longitudinal axis.

[0023] Illustratively, the method further includes the steps ofproviding a second patient support surface, coupling the second patientsupport surface to the frame, and simultaneously rotating the firstpatient support surface and the second patient support surface. The stepof simultaneously rotating the first patient support surface and thesecond patient support surface comprises rotating the first patientsupport surface and the second patient support surface by at least 180°about the longitudinal axis.

[0024] Illustratively, the backboard includes an inflatable portion andthe second patient support surface includes an inflatable portion.

[0025] Further illustratively, the method comprises the step ofinflating the inflatable portion of the backboard before the rotatingstep. The method illustratively includes the further step of deflatingthe inflatable portion of the backboard.

[0026] Illustratively, the method includes the further step of inflatingthe inflatable portion of the second support surface.

[0027] Further illustratively, the therapy bed includes a fluid supplyconfigured to selectively inflate and deflate the inflatable portion ofthe backboard and the inflatable portion of the second patient supportsurface.

[0028] Illustratively, the method further includes the step of removingthe backboard from the therapy bed after the step of rotating the firstpatient support surface and the second patient support surface.

[0029] Further illustratively, the step of releasably coupling comprisesthe step of mechanically coupling the backboard to the frame through aplurality of connectors.

[0030] Additional objects, features, and advantages of the inventionwill become apparent to those skilled in the art upon consideration ofthe following detailed description of the illustrated embodimentexemplifying the best mode of carrying out the invention as presentlyperceived.

BRIEF DESCRIPTION OF THE DRAWINGS

[0031] The detailed description particularly refers to the accompanyingfigures in which:

[0032]FIG. 1 is a perspective view illustrating a proning bed of thepresent invention;

[0033]FIG. 2 is a perspective view, with portions broken away,illustrating a base and a patient support surface support assemblylocated at a foot end of the bed to control movement of the patientsupport surface;

[0034]FIG. 3 is a perspective view, with portions broken away,illustrating additional details of the support assembly of the presentinvention;

[0035]FIG. 4 is a side elevational view illustrating movement of thesupport assembly to position the patient support surface in either aTrendelenburg or a reverse Trendelenburg position; FIG. 5 is aperspective view illustrating another embodiment of the presentinvention in which a modular patient support assembly is configured tobe coupled to receptacles on the support assembly;

[0036]FIG. 6 is a perspective view illustrating a proning bed of thepresent invention, with a patient on a support surface in a supineposition;

[0037]FIG. 7 is a sectional view taken through the patient supportassembly of FIG. 1 illustrating top doors in an open position;

[0038]FIG. 8 is a sectional view through the patient support assembly ofFIG. 6 with the proning doors in a closed and latched position and witha lifting apparatus on each side of the patient support surface, eachlifting apparatus being adjusted to move the patient support surface toits lowermost position relative to support arms of the bed;

[0039]FIG. 9 is a sectional view similar to FIG. 8 in which the liftingapparatus are actuated to move a patient support surface upwardlyrelative to side support arms of the bed;

[0040]FIG. 10 is a perspective view similar to FIG. 6, illustrating thepatient support surface in its raised position relative to the side armsof the bed;

[0041]FIG. 11 is a sectional view taken through the patient supportsurface of FIG. 5, after the bed is operated to rotate the supportsurface, thereby turning the patient over to a prone position;

[0042]FIG. 12 is a perspective view illustrating the patient supportsurface of the bed moved to a Trendelenburg position;

[0043]FIG. 13 is a perspective view of the bed of the present inventionwith the patient support surface in a reverse Trendelenburg position;

[0044]FIGS. 14 and 15 illustrate actuation of a lifting mechanisms onopposite sides of the bed for providing patient rotation using only thelifting mechanisms actuated in opposite, alternating directions;

[0045]FIG. 16 illustrates insertion of an x-ray cassette below thepatient support surface of the present invention;

[0046]FIG. 17 is a sectional view illustrating actuation of the x-raycassette holder to move the x-ray cassette close to a patient supportsurface to improve imaging; FIG. 18 is a chart illustrating rotation ofthe patient support surface about both a lateral axis and a longitudinalaxis; and

[0047]FIG. 19 is a sectional view illustrating a compression therapyapparatus of the present invention.

DETAILED DESCRIPTION OF THE DRAWINGS

[0048] Referring now to the drawings, FIG. 1 illustrates a bed 10 havinga base 12 which includes opposite side members 14 and 16 and crossmembers 18 and 20 extending between side members 14 and 16. A supportassembly 22 is located at a foot end 24 of bed 10. Support assembly 22supports a patient support assembly 26 in a cantilevered fashion.Therefore, the head end 25 of bed 10 is open to facilitate access to thepatient 56.

[0049] Support assembly 22 is pivotably coupled to pivot blocks 28 ofbase 12 by pivot connections 30. Therefore, support assembly 22 canpivot about axis 32 in the directions of double-headed arrow 34. Asdiscussed in detail below, the support assembly 22 is movable up anddown in the direction of double-headed arrow 36 to raise and lower theheight of patient support assembly 26. Also as discussed below indetail, support assembly 22 can rotate the patient support assembly 26about its longitudinal axis 38 as indicated by double-headed arrow 40.Support assembly 22 can rotate the patient support assembly 26 in eitherdirection a full 360°.

[0050] Patient support assembly 26 includes a pair of horizontallyextending arms 42 and 44 which are coupled to a cruciform-shaped plate46 of support assembly 22. Arms 42 and 44 extend away from supportassembly 22 in a cantilevered fashion. An end beam 46 extends betweenarms 42 and 44 at a distal end of patient support assembly 26. A patientsupport surface 50 is coupled between arms. When it is desired to rotatea patient, a proning support surface 52 is also coupled between arms 42and 44. Proning support surface 52 includes a recess 54 for receivingthe head of a patient 56. Support surfaces 50 and 52 are shown in anillustrative representation only. It is understood that support surfaces50 and 52 will include selective placement of foam, air bladders,fluidized bladders, or other suitable support surfaces to reducepressure on the patient 56 and/or support an unstable spine of thepatient 56. The support surfaces 50 and 52 may include contoured supportsurfaces to minimize pressure on the patient. Layers of air and beadscan be positioned over the contoured support surfaces. A vacuum can beselectively applied to the bead packs to further conform the supportsurfaces to the patient.

[0051] Cruciform 46 is coupled to a drive mechanism 55 includingrotatable, annular rack 57 which is held in place on a front surface 58of support assembly 22 by rotatable bearings 60 which are coupled tofront surface 58. Cruciform 46 includes four arms which are each securedto the annular rack 57. A motor 62 and gear 64 are located on supportassembly 22. Gear 64 engages annular rack 57 to rotate the annular rack57 relative to the front surface 58. Therefore, the support arms 42 and44 coupled to the cruciform also rotate in the direction ofdouble-headed arrow 40. As illustrated in FIGS. 2 and 3, the arms 42 and44 extend through the cruciform 46 and are then welded to the cruciform46. Arms 42 and 44 are also welded to a rear support plate 66. Extensionsections 68 are welded between the support plate 66 and the cruciform 46at locations between the support arms 42 and 44.

[0052] The support assembly 22 includes a movable frame 70 which ismovable relative to outer supports 72. FIG. 2 illustrates the frame 70in an upwardly extended position.

[0053] Opposite outer supports 72 each include a rodless cylinder 74having a movable carriage 76. Movable carriage 76 is coupled to asidewall 78 of movable frame 70 by fasteners 80. A guide cylinder 82 islocated adjacent each rodless cylinder 74. A guide block 84 slides overeach cylinder 82. Guide block 84 is coupled to sidewall 78 of frame 70by fasteners 86.

[0054] Illustratively, rodless cylinders 74 are Lintra® rodless cylinderavailable from Norgren located in Rockford, Illinois. An air supply isused to control movement of the carriages 76 on the rodless cylinders 74to move the movable frame 70 of the support assembly 22 up and down inthe directions of double-headed arrow 36. Since the annular rack 57, thecruciform 46 and the patient support assembly 26 are all coupled to themovable frame 70, the support surface 26 moves up and down in thedirection of double-headed arrow 36 with the movable frame 70.Illustratively, the cylinders 74 provide and 8-9 inch lift. It isunderstood that hydraulics, lead screws, or other suitable liftingmechanisms can be used with the present invention.

[0055] The cantilevered design of the present invention advantageouslysuspends the patient support surface 26 from the support assembly 22.This permits full body C-arm access. In addition, a head end 25 of thebed is accessible for performing procedures on the patient 56. A supportbar 77 can extend between the head end 25 of patient-support surface 26and base 12 if desired. The support bar 77 can be moved into the supportposition engaging support surface assembly 26 while the patient 56 is onsupport surface 50. The support bar 77 can be removed from supportsurface assembly 26 for C-arm access or rotation.

[0056] The support assembly 22 is coupled to base 12 by blocks 88.Blocks 88 include a front angled stop 90 and a rear angled stop 92 whichlimit pivotable movement of the support assembly 22 relative to the base12. As illustrated in FIG. 4, the support assembly 22 is pivotablerelative to base 12 to move the patient support assembly 26 between aTrendelenburg position illustrated in solid lines in FIG. 4 to a reverseTrendelenburg position illustrated in dotted lines in FIG. 4.Illustratively, the pivotable movement is about +/−15° relative tohorizontal in either direction as illustrated by angles 91 in FIG. 4.Front stop 90 engages base 12 when the patient support surface is in theTrendelenburg position shown in solid lines in FIG. 4. Second stop 92engages the base 12 when the support assembly is in the reverseTrendelenburg position as shown in dotted lines in FIG. 4.

[0057] Pivotable movement of support assembly 22 about axis 32 iscontrolled by a cylinder 94 pivotably coupled to a cross member 96 whichextends between arms 14 and 16 of base 12. A fluid source 98 is alsocoupled to cross member 96 to control movement of a piston 100 relativeto cylinder 94 between an extended position and a retracted position.Piston 100 is pivotably coupled to support assembly 22. Therefore,retraction of piston 100 causes movement of the support assembly 22forward to the Trendelenburg position. Extension of piston 100 causespivotable movement of the support assembly 22 to the reverseTrendelenburg position.

[0058] Although the side arms 42 and 44 of the patient support assembly26 are shown as solid arms in FIG. 1, it is understood that the sidearms 42 and 44 may be shorter pieces cut off adjacent support assembly22 as illustrated by arms 102 and 104 in FIG. 5. Since arms 102 and 104are illustratively hollow receptacles, the remainder of the patientsupport assembly 26 includes arm extensions 106 and 108 which slide intothe open ends of receptacle arms 102 and 104 extending from supportassembly 22. Therefore, a patient could be transported directly from atrauma situation on the patient support surface 50 using suitablehandles (not shown). The patient support assembly 26 and surface 50 maythen be attached to the open ends of arms 102 and 104 and secured inposition to form a cantilevered support surface 26 for the patient 56without having to move the patient 56 from the support surface 50.Operation of the bed is then as described above.

[0059] The bed can be programmed to provide rotational therapy to thepatient. The bed can also be used to prone the patient 56 so that thepatient lies face down on the proning support surface 52.

[0060] In FIGS. 6-15, these elements referenced by numbers from FIGS.1-5 perform the same or similar function. Patient support assemblyincludes a lower set of doors 110 and an upper set of doors 112. Lowerset of doors 110 supports the patient support surface 50 for holding thepatient in a supine position. Doors 110 and 112 are pivotably coupled tolifting apparatus 114 and 116. A first lifting apparatus 114 is coupledto arm 42, and a second lifting apparatus 116 is coupled to arm 44. Eachlifting apparatus 114 and 116 includes an outer rectangular support 118having a top surface 120 and a bottom surface 122. Each liftingapparatus 114, 116 further includes first and second lifting cylinderassemblies 124 and 126 located within side arms 42, 44, respectively.The first and second cylinder assemblies 124 and 126 each include a pairof cylinders 128, 130 which are coupled to arms 42, 44 by pivotconnections 132 and 134, respectively. Cylinders 128 and 130 includepistons 136 and 138, respectively, which are pivotably coupled to topsurface 120 of movable support 118 at locations 140. Illustratively,cylinders 128, 130 are hydraulic cylinders controlled by a suitablecontroller located within support assembly 22. Lines for controllingcylinders 128, 130 can be run through the arms 142, 144 to minimize lineclutter.

[0061] The pistons 136, 138 are movable from a retracted positionillustrated in FIG. 6 to an extended position illustrated in FIG. 10. Inthe retracted positions, pistons 136 and 138 position the supportsurface 50 at a lowermost position relative to arms 42 and 44 of theframe. In the extended position, the pistons 136 and 138 lift themovable support 118 and the patient support surface 50 coupled theretoupwardly to the position shown in FIG. 10. Arms 42 and 44 each areconfigured to include apertures 142 shown in FIG. 5 to permit thecylinders 128, 130 and pistons 136, 138 to move upwardly past a topsurface 144 of frame arms 42, 44.

[0062] The bed 10 is configured so that a patient can be transportedfrom a remote trauma location and positioned directly on the bed asillustrated in FIG. 7. Illustratively, the patient is transported to thebed 10 on a backboard 146. Illustratively, the backboard 146 may includeair bladders, foam padding, and/or contoured sections to facilitatetransport of the patient and to provide a pressure reducing surface whenthe backboard 146 is located on the bed 10. The backboard 146 mayillustratively include a self-inflating surface, such as a Therm-A-Rest®mattress, for use in the field. When the backboard 146 is loaded intothe bed 10, connectors are provided for coupling air bladders on thebackboard to the air supply system and valves already located on the bed10. Connectors are also provided for coupling the backboard 146 to thebed 10 mechanically and electrically.

[0063] As illustrated in FIG. 7, the bottom door assembly 110 includes afirst door 148 pivotably coupled to the first lifting mechanism 114 anda second door 150 pivotably coupled to the second lifting mechanism 116.The first door 148 includes a first section 152 pivotably coupled to thefirst lifting mechanism 114 by hinge 154 and a second portion 156pivotably coupled to the first portion 152 by hinge 158. Second door 150includes a first portion 160 pivotably coupled to the second liftingmechanism 116 by hinge 162 and a second portion 164 pivotably coupled tothe first portion 160 by hinge 166. Latches 168 are used to secure thefirst and second doors 148 and 150 in a closed position illustrated inFIG. 7 to provide a support for the backboard 146. Illustratively, apair of air bladders 170 are located on an inner surface of doors 148and 150 to provide a support for backboard 146. Alternatively, thepatient can be situated directly on the air bladders 170 if the patienthas not been transported to the bed on the backboard 146.

[0064] The proning doors 112 similarly include a first door 172 and asecond door 174 shown in an open position in FIG. 7. Door 172 includes afirst portion 176 pivotably coupled to first lifting apparatus 114 byhinge 178. Door 172 further includes a second portion 180 pivotablycoupled to first portion 176 by hinge 182. Door 174 includes a firstportion 184 coupled to second lifting apparatus 116 by hinge 186 and asecond portion 188 pivotably coupled to first portion 184 by hinge 190.A first latch portion 192 is coupled to second door portion 180 of door172, and a second latch portion 194 is coupled to second door portion188 of second door 174. Air bladders 196 are also coupled to second doorportions 180 and 188. FIG. 7 also illustrates a pair of inner inflatableside bladders 198 and 200 located along opposite sides of the patient56. FIG. 7 illustrates the top doors 172 and 174 in an open position. Inthe open position, first door portions 176 and 184 rest upon top surface120 of the first and second lifting apparatus 114, 116, respectively.Therefore, the second door portions 180 and 188 can lie adjacent outersurfaces 118 of the first and second lifting apparatus 114 and 116,respectively, to conserve space. Air bladders 196 may be deflated toconserve additional space.

[0065] After the patient is transported to the bed 10 from an injurysite or other location on backboard 146, the patient 56 and thebackboard 146 are loaded into the bed 10 as illustrated in FIG. 7 withthe patient in the supine position. If it is desired to prone thepatient 56 for a medical procedure or therapy, the doors 172 and 174 areclosed in the direction of arrows 202 and 204 of FIG. 7, respectively.Once the doors are moved to a closed position illustrated in FIGS. 6 and8-10, latches 192 and 194 are connected to secure the doors 172 and 174together. It is understood that any type of latch mechanism can be usedto hold the doors 172 and 174 in the closed position. As shown in FIG.8, the air bladders 196 are configured to lie over the patient 56 whenthe doors 172 and 174 are closed.

[0066] In FIG. 8, the pistons 136 and 138 of cylinders 128 and 130,respectively, are in the retracted position shown in FIG. 6. Therefore,the arms 42 and 44 are located adjacent top surface 120 of support 118of the first and second lifting apparatus 114 and 116. Therefore, bottomsurfaces of arms 42 and 44 are spaced apart from a bottom surface 122 offirst and second lifting apparatus 114 by a distance 206. In theposition of FIGS. 6 and 8, the patient 56 is located at the lowermostsupport position relative to arms 42 and 44.

[0067] When it is desired to rotate or prone the patient, it isdesirable to move the patient's center of gravity to a location above apivot axis 138 of patient support assembly 26. Therefore, beforerotating the patient 56, the first and second lifting apparatus 114 and116 are actuated to extend the pistons 136 and 138 from cylinders 128and 130 of the first and second cylinder arrangements 124 and 126. Byextending the pistons 136 and 138, the top surfaces 120 of supports 118of the lifting apparatus 114 and 116 move upwardly to the positionillustrated in FIGS. 9 and 10. FIG. 9 shows that the distances betweenthe bottom surfaces arms 42 and 44 is closer to the bottom surfaces 122of supports 118 lifting apparatus 114 and 116 in the FIG. 9configuration. The patients center of gravity 208 is at or slightlyabove the location of pivot axis 38. This positioning of patient 56facilitates the rotating operation and provides less of a fallingsensation for the patient 56 as rotation begins.

[0068] A controller of the present invention is configured to positionthe patient properly for proning automatically. A caregiver enters thepatient's height and weight using an input device, and then thecontroller calculates a location of the center of gravity of the patientusing known algorithms. The controller then sends appropriate controlsignals to the cylinders 128 and 130 to lift the patient a desireddistance. Once the patient is positioned as illustrated in FIGS. 9 and10, the controller actuates the drive motor and gear which drives theannular ring and rotates the cruciform 46 and arms 42 and 44 in thedirection of arrows 210 in FIG. 11 until the patient has been proned.Once in the prone position of FIG. 11, latches 168 are opened to permitdoors 148 and 150 to be moved away from the patient 56. Backboard 146can then be removed to expose a back of the patient 56. Before thepatient is moved to the prone position shown in FIG. 11, an appropriatehead support member (not shown) is coupled to the proning doors 112 tosupport the patient's head and while in the prone position.Alternatively, the length of doors 172 and 174 may be extended andformed to include a recess for receiving the patient's face.

[0069] As shown in FIGS. 12 and 13, lifting apparatus 114, 116 may alsobe used for moving the patient support surface 50 from a Trendelenburgposition shown in FIG. 12 to a reverse Trendelenburg position shown inFIG. 13. Using the first and second lifting apparatus 114, 116 in thismanner eliminates the need for a separate cylinder 94 and a pivotableconnection between support 22 and base 12. In other words, the support22 may be rigidly coupled to base 12 when the first and second liftingapparatus 114 and 116 are used for the Trendelenburg and reverseTrendelenburg positioning.

[0070] As shown in FIG. 12, when the pistons 136 and 138 of the firstpair of cylinders 124 are in the fully retracted position and thepistons 136 and 138 of the second set of cylinders 126 are in the fullyextended position, the patient support surface 50 moves to aTrendelenburg position. Conversely, when the pistons 136 and 138 of thefirst set of cylinders 124 are moved to fully extended and the pistons136, 138 and the second set of cylinders 126 are moved to the fullyretracted position, the patient support 50 moves to a reverseTrendelenburg position as shown in FIG. 13.

[0071] Therefore, the lifting apparatus 114, 116, could also be used toprovide rotation of patient 56 about a lateral axis perpendicular tolongitudinal axis 38 and the patient 56. In other words, the liftingapparatus 114, 116 can be used to move the patient back and forthbetween the FIG. 12 position and the FIG. 13 position.

[0072] As shown in FIGS. 14 and 15, the first and second liftingapparatus 114, 116 may also be used to provide limited rotationaltherapy for the patient 56 about axis 38. The main drive motor withinsupport assembly 22 can also be used for rotational therapy. In otherwords, the entire frame assembly 42, 44, and 46 may be rotated back andforth about axis 38 to provide rotational therapy for the patient. Toprovide the rotational therapy using only the first and second liftingapparatus 114, 116, the following sequence is used. The pistons 136 and138 of the first and second cylinder pairs 124 and 126 in liftingapparatus 114 are moved to the retracted position while the pistons 136and 138 of the cylinders 124 and 126 of lifting apparatus 116 are movedto the extended position as shown in FIG. 14. This causes the support118 of first lifting apparatus 114 to move downwardly in the directionof arrow 212 and the support 118 of second lifting apparatus 116 to moveupwardly in the direction of arrow 214. Next, the pistons 136 and 138 ofthe cylinder pairs 124 and 126 of lifting apparatus 114 are extended tomove the support 118 of lifting apparatus 114 upwardly in the directionof arrow 216 of FIG. 15. Simultaneously, the pistons 136 and 138 of thecylinder pairs 124 and 126 of lifting apparatus 116 are retracted tomove the support 118 of second lifting apparatus 116 downwardly in thedirection of arrow 218. Therefore, as shown in FIGS. 14 and 15,rotational therapy can be provided to the patient 56 by alternatelyextending and retracting, in opposite timing, the pistons 136 and 138 ofthe cylinder pairs 124 and 126 of first and second lifting apparatus 114and 116.

[0073]FIGS. 16 and 17 illustrate an x-ray carriage 220 including a frame222 having a handle 224 and a recessed portion 226 configured to receivean x-ray cassette 228. Carriage 220 also includes a lifting mechanism230 best illustrated in FIG. 17 which is operated by a crank 232. Thecarriage 220 is designed to be inserted below bladders 170 and backboard146 to lie on doors 156 and 164. Appropriate openings (not shown) areformed in door sections 152 or 160 to permit insertion of the carriage220. Once the carriage 220 is positioned at a desired location, liftingapparatus 230 is actuated to lift the x-ray cassette 228 upwardly asshown in FIG. 17. The bladder 170 above the x-ray cassette 228 isdeflated to permit the x-ray cassette 228 to be moved upwardly against abottom surface of backboard 146. By moving the x-ray cassette 128 closerto the bottom surface of backboard 146, imaging is improved.

[0074] In another embodiment of the present invention, the apparatusincludes surface pressure sensing integrated into the patient supportsurface. Specifically, an array of capacitive pressure sensors 240 arecoupled to a top surface of patient support bladders 242 as shown inFIG. 16. Foam support surfaces may be located in the air bladders 242,if desired. As a patient 56 changes positions on the support bladders242, or is rotated within the bed 10, pressure within each bladder 242is adjusted based on inputs from the pressure sensor array 240 to keepinterface pressure below capillary closure pressure or at as low apressure as possible.

[0075] As discussed above, the bed of the present invention can be usedto provide rotation about longitudinal axis 38 and about a lateral axisgenerally perpendicular to the longitudinal axis 38. The bed can movethe patient about the longitudinal axis 38 up to 360°. At the same time,Trendelenburg angles of +/−15° are also possible. For instance, apatient requiring head elevation and proning can be in reverseTrendelenburg position shown in FIG. 13 while in the supine position. Asthe patient 56 is rotated to the prone position, the bed also actuatesthe lifting apparatus or tilting apparatus to move the patient supportsurface to the Trendelenburg position. Therefore, when the patient is inthe prone position, the patient's head will still be elevated. A graphshown in FIG. 18 illustrates rotation angles about the lateral axis andlongitudinal axis 38.

[0076]FIG. 19 illustrates an external chest compression device of thepresent invention. Illustratively, separate air cushions 250, 252, 254,256 and 258 surround the patient 56 when the proning doors 172 and 174are closed. The air cushions are all controlled separately. Each aircushion, 250, 252, 254, 256, and 258 may be divided into separate zones.For instance, zone 258 located below patient 56 may be divided into fourseparate zones 260, 262, 264 and 266 as indicated. Cushion 250 and achest and abdomen zone 262 of lower air cushion 258 are increased inpressure to place the patient's chest cavity under varying amounts ofexternal pressure. This may provide respiratory benefits to the patient56, similar to prone positioning. Cushion 250 and chest and abdomen zone262 of lower air cushion 258 may also be used to provide chestphysiotherapy such as percussion or vibration therapy, either separatelyor together. Inflation and deflation of the cushions may also besynchronized to a patient's breathing pattern and then adjusted to weanthe patient from a respirator. Cushions 252, 254, 256 and the leg andfoot zones 264 and 266 of bottom cushion 258 are inflated simultaneouslyto provide deep vein thrombosis therapy. Inflation and deflation of allthe zones is controlled by a blower coupled to a main controller of thebed 10. The controller of bed 10 can also be connected to variousmonitoring outputs from devices such as SaO₂, EKG, respiration, etc.,and the pressure in the zones can be varied based upon outputs fromthese monitoring device outputs to synchronize treatment with thephysical parameters detected. Interface pressure sensors may be includedin each cushion to provide feedback to the controller.

[0077] Monitoring devices, such as a patient's blood oxygen level sensorSaO₂ monitoring systems are well known. The controller of the presentinvention is also used to control the frequency of rotation of thepatient using feedback from a blood oxygen saturation monitor coupled tothe patient. The processor determines whether the patient requires moreor less frequent rotation based upon the blood oxygen saturation levelsdetected and either suggests the change in rotation frequency to thecaregiver via a display or automatically adjusts the frequency ofrotation of the patient support surface based on the blood oxygensaturation levels detected. The illustrated frequency is about 0.67degrees per second. This frequency is adjusted based on the output ofthe blood oxygen saturation monitor.

[0078] A controller of the present invention is used to program variousfeatures of the bed to provide a sequence of treatments to the patientselected from a matrix of possible bed positions and therapies. Thecontroller can provide continuous lateral rotation of the patient aboutlongitudinal axis 38 at different angles and frequencies. The controllermay be programmed to rotate the bed further to one side than to theother during the continuous lateral rotation. In addition, thecontroller can be programmed to provide head elevation, for example, atselected times. The controller can be coupled to various types ofsensors, such as discussed above including sensors for measuring bloodoxygen level, oxygen index, end tidialed CO₂, etc., to adjust thetreatment or position of the patient based on outputs from thesesensors. Although the invention has been described in detail withreference to a certain illustrated embodiment, variations andmodifications exist within the scope and spirit of the present inventionas described and defined in the following claims.

What is claimed is:
 1. An apparatus for supporting a patient and forpositioning an x-ray cassette comprising: a frame; a patient supportassembly coupled to the frame and configured to be rotated about alongitudinal axis to position the patient in at least a supine positionand a prone position, the patient support assembly including a firstpatient support for supporting a patient in a supine position and asecond patient support for supporting the patient in a prone position;and a holder apparatus adapted to receive an x-ray cassette andconfigured to position the x-ray cassette relative to the patient, theholder apparatus being supported by the patient support assembly.
 2. Theapparatus of claim 1, wherein the first patient support includes aninflatable bladder and the holder apparatus is positioned below theinflatable bladder such that the inflatable bladder is positionedbetween the holder apparatus and the patient.
 3. The apparatus of claim2, wherein the holder apparatus includes a base portion and a liftingmechanism configured to move the x-ray cassette relative to the baseportion.
 4. The apparatus of claim 3, wherein x-ray cassette ispositioned relative to the patient by at least partially deflating theinflatable bladder and moving the x-ray cassette relative to the liftingmechanism such that the x-ray cassette is spaced apart from the baseportion.
 5. The apparatus of claim 2, further comprising a backboard,the backboard being removably coupled to the patient support assembly tofacilitate transport of the patient to and from the apparatus.
 6. Theapparatus of claim 1, wherein the patient support assembly is furtherconfigured to position the patient in a Trendelenburg position and areverse Trendelenburg position.
 7. The apparatus of claim 1, furthercomprising a drive mechanism operably coupled to the patient supportassembly and configured to rotate the patient support assembly about thelongitudinal axis and a controller operably coupled to the drivemechanism and configured to control the rotation of the patient supportassembly.
 8. The apparatus of claim 7, wherein the drive mechanism is arotatable motorized drive mechanism.
 9. The apparatus of claim 1,wherein the holder apparatus is moveable from a first position supportedby the patient support assembly and a second position spaced apart fromthe patient support assembly.
 10. A method of positioning an x-raycassette relative to a patient being supported at least by an inflatablebladder of a patient support, the method comprising the steps of:providing a holder apparatus including a base portion, the holderapparatus being adapted to receive an x-ray cassette; positioning theholder apparatus below the inflatable bladder of the patient support;and deflating at least partially the inflatable bladder to reduce thedistance between the patient and the x-ray cassette.
 11. The method ofclaim 10, wherein the holder apparatus is further configured to move thex-ray cassette between a first position wherein the x-ray cassette isreceived by the base portion and a second position wherein the x-raycassette is spaced apart from the base portion.
 12. The method of claim11, further comprising the step of moving the x-ray cassette from thefirst position to the second position while the holder apparatus ispositioned below the inflatable bladder.
 13. The method of claim 12,wherein the patient support further comprises a backboard supported bythe inflatable bladder, the patient being supported by the backboard,and wherein the inflatable bladder is deflated such that the x-raycassette is positioned proximate to the backboard when the x-raycassette is in the second position.
 14. An x-ray carriage forpositioning an x-ray cassette, the x-ray carriage comprising: a basehaving a recessed portion adapted to receive an x-ray cassette; alifting mechanism coupled to the base and configured to move the x-raycassette relative to the base such that the x-ray cassette is moveablefrom a first position wherein the x-ray cassette is received by therecess portion and a second position wherein the x-ray cassette isspaced apart from the recess portion; and an actuator configured toactuate the lifting mechanism.
 15. The x-ray carriage of claim 14,wherein the lifting mechanism includes a scissor lift.
 16. The x-raycarriage of claim 14, wherein the actuator is a crank.
 17. The x-raycarriage of claim 14, wherein the base includes a handle portion. 18.The x-ray carriage of claim 14, wherein the second position isvertically spaced apart relative to the first position.
 19. The x-raycarriage of claim 14, wherein a front portion of the base includes atapered portion.